What this physician learned from being an ailing patient
I felt a gust of sharp pain a couple of centimeters to the right of my belly button. It will subside, I thought. All pain subsides. It was an easy dictum to follow as a 39-year-old pediatric eye doc who last spent a night in the hospital as a patient in 1977.
I’d undergone bilateral laparoscopic inguinal hernia repair ten days earlier, so I was accustomed to brief squalls of discomfort after certain maneuvers — in this case, 30 minutes on the elliptical machine. My adherence to post-operative instructions was incomplete, but I reasoned that after more than a week of smooth sailing, the chance of an untoward event w...
Source: Kevin, M.D. - Medical Weblog - March 22, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/andrew-schneier" rel="tag" > Andrew Schneier < /a > Tags: Physician Nephrology Source Type: blogs
Ten Years In
My first day as an attending general surgeon in Cleveland, Ohio was August 7th, 2006. I saw one patient with a hernia in the office that day and then, around 430 pm, the call came in from the pediatric ER about a kid with abdominal pain. Some healthy 17 year old boy with obvious early appendicitis. I booked the case, tip-toed my way through the laparoscopic appendectomy uneventfully and went home feeling awful proud of myself. It was exactly how I envisioned a life as a general surgeon. I had been a confident 5th year resident. I hadn't done a fellowship. I had felt ready. I was read...
Source: Buckeye Surgeon - March 3, 2017 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
A Connection to Samoa
BY TIM DEPP, MDNo one knows when the first Samoans landed on what is now the Samoan Islands, the destination of our journey. The Samoans have most likely been there for several thousand years, since the Lapita people (ancestors of the Polynesians) migrated there between 1200 and 1000 BC, making Samoan culture, in a word, ancient. Spaniards, pirates, and missionaries came and went. And "fa'asamoa," the Samoan way, has continued, albeit somewhat changed. Important distinctions are maintained, including the divide between the sovereign nation of Samoa (formerly Western Samoa) and American Samoa (a U.S. protect...
Source: Going Global - January 6, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Was Martin Shkreli Arrested For Hiking Drug Prices?
By SAURABH JHA, MD
I don’t subscribe to conspiracy theories. I never believed a second shot was fired. Nor do I believe that Bill Clinton was stalked on the grassy knoll. So I won’t speculate that Martin Shkreli’s arrest for alleged securities fraud that happened years ago is related to his raising Daraprim’s price by 5500 %.
Just because something isn’t suspicious doesn’t mean that it isn’t odd.
Shkreli is a perfect poster child for rapacious pharmacocapitalism – so perfect that it’s odd. He openly admits “I have a sworn duty to my shareholders to maximize profit.” Shkreli’s admission is odd not f...
Source: The Health Care Blog - December 22, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Saurabh Jha Source Type: blogs
Martin Shkreli and Pharmacocapitalism’s Inconvenient Truth
By SAURABH JHA, MD
I don’t subscribe to conspiracy theories. I never believed a second shot was fired. Nor do I believe that Bill Clinton was stalked on the grassy knoll. So I won’t speculate that Martin Shkreli’s arrest for alleged securities fraud that happened years ago is related to his raising Daraprim’s price by 5500 %.
Just because something isn’t suspicious doesn’t mean that it isn’t odd.
Shkreli is a perfect poster child for rapacious pharmacocapitalism – so perfect that it’s odd. He openly admits “I have a sworn duty to my shareholders to maximize profit.” Shkreli’s admission is odd not f...
Source: The Health Care Blog - December 22, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Saurabh Jha Source Type: blogs
Symptoms of Unknown Origin – The Prevalence of False Diagnosis of Disease
This study only raises the question, “How common is the error of assigning a false diagnosis of a disease?”
The literature is surprisingly silent on the prevalence of false diagnoses. I can find only one dated study of the prevalence of false diagnoses in a population. In 1967, Berman and Stamm studied over 100 children in the Seattle school system that carried a diagnosis of heart disease. (2.) Rounding off the figures, only 20 percent were found to have heart disease on careful study. Eighty percent did not have heart disease. The most telling finding was the presence of severe psychological and physical disability i...
Source: The Health Care Blog - September 16, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Longevity and Long-Term Care: The Medical Crisis of the 21st Century : Part 2
Throughout the 20th century, most Americans saw “longevity” as a goal. If we took care of our bodies, we reasoned, we could “live longer and better.”
But in the 21st century, I suspect that some of us will learn to fear “longevity” the way we now fear cancer.
This is the second in a series of posts that will explore the anguish that some experience when they live into their late eighties and nineties–and how we, as a society, can address the hardships of “old, old age.”
Senile Dementia
Thanks to better diets, exercise, and advances...
Source: Health Beat - May 19, 2014 Category: American Health Authors: Maggie Mahar Tags: Knocking on Heaven's Door Alzheimer's Alzheimer's drugs Compassion and Choices fast medicine Long-term care longevity over-treatment pacemakers palliative care senile dementia slow medicine Uncategorized Consumer Reports Katy B Source Type: blogs
The LITFL Review 128
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
Welcome to the 128th edition, brought to you by:
Kane Guthrie [KG] from LITFL
Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles
Brent Thoma [BT] from BoringEM, and ALiEM
Chris Ni...
Source: Life in the Fast Lane - March 4, 2014 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: eLearning Featured Intensive Care Pediatrics Toxicology #FOAMped #FOAMtox #meded FOAMcc FOAMed LITFL R/V LITFL review Source Type: blogs
Hospital Horrors
The bullet hit me just below my rib cage, punching out a huge section of my liver and collapsing my right lung. Waves of pain rippled round my chest like a stone thrown in a still pond or echoes reverberating off sandstone cliffs.I gasped for breath but could find none. I tried to scream but had no voice.I rolled onto my back, clutching the entry wound with both hands, felt the wet, blood-soaked T-shirt beneath my fingers, sodden and cold.Wait… A bizarre fact flickered across my consciousness. The temperature of the human body is 98.6 degrees Fahrenheit. The blood spilling from my torn abdomen should be warm—not cold.I...
Source: LifeAfterDx--The Guardian Chronicles - February 1, 2014 Category: Diabetes Authors: Wil Source Type: blogs
Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!).
These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs
Where you stand depends on where you sit
I know from personal interactions that the CEO of Steward Health Care System has an excellent sense of humor. But he certainly cannot have meant to be funny when he appeared at the state health cost trends hearings hosted last week by the state Health Policy Commission and appealed to the state to enact more health cost containment legislation that would further limit prices for higher-cost doctors and hospitals. Julie Donnelly at the Boston Business Journal summarized:The demand for additional regulation is somewhat unusual given that de la Torre is the CEO of one of the few for-profit health systems in t...
Source: Running a hospital - October 6, 2013 Category: Health Managers Source Type: blogs
Boulder Community Hospital computer system crash: Either you're in control of your information systems, or they're in control of you
Yet another health IT crash, "prolonged" this time, from some unspecified "glitch":Boulder Community Hospital computer system crash frustrates patientsOfficials say it could take until Friday for outage to be resolvedBy Brittany AnasCamera Staff WriterPosted: 03/18/2013 07:23:23 PM MDTUpdated: 03/18/2013 07:24:16 PM MDTA prolonged computer system outage is preventing Boulder Community Hospital from accessing patient records -- making it difficult for people to schedule surgeries, get test results and make appointments for routine blood work.Meditech, the system used by the hospital to manage patient...
Source: Health Care Renewal - March 20, 2013 Category: Health Medicine and Bioethics Commentators Tags: glitch Meditech healthcare IT crash Boulder Community Hospital Rich Sheehan healthcare IT risks Source Type: blogs
Marfan’s Disease
Pathophysiology of Marfan’s disease
Marfan’s disease is
1) disease of connective tissue
2) marked by dilation of aorta and aortic dissection in a young person
Signs and Symptoms
1) tall stature with long lower torso
2) long limbs and digits
3) pectus carinatum (pigeon breast)
4) inguninal hernias
5) hypermobile joints
6) severe chest pain
7) lightheadedness
8) retinal detachment
9) myopia
10) bilateral subluxation of lines in outward and upward direction (ectopia lentis)
11) aortic regurgitation
12) mitral prolapse and “floppy” mitral valve
13) abnormal head (enlarged supraorbital ridges)
14) kypho...
Source: Inside Surgery - March 17, 2013 Category: Surgeons Authors: Editor Tags: Pediatrics Surgpedia ectopia lentis FBN1 lens subluxation rfibrillin 1 Source Type: blogs
Dash 22
The consult came in around 3:30 on a Friday. The surgeon wasn't on call but his partner was tied up and he, the surgeon, felt obligated to see the new patient before it got too late. To do otherwise is known as a "dick move" in the world of small private surgical practice. The computer record outlined the picture of a man in his late seventies with an unremarkable medical history. He only took something for gout and various other over the counter vitamins. He took something called Life-X 3000. The consult request was "evaluate for gallbladder disease". The patient had been adm...
Source: Buckeye Surgeon - February 10, 2013 Category: Surgeons Authors: Jeffrey Parks MD Source Type: blogs
